Lehne's Pharmacology for Nursing Care 9th Edition by Jacqueline Burchum
Lehne's Pharmacology for Nursing Care 9th Edition by Jacqueline Burchum
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Chapter 93: Antiviral Agents I: Drugs for Non-HIV Viral Infections
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | extend this patient’s drug therapy to twice daily for 12 months. |
| b. | give intravenous foscarnet every 8 hours for 2 to 3 weeks. |
| c. | increase the acyclovir dose to 800 mg PO 5 times daily. |
| d. | order intravenous valacyclovir [Valtrex] 1 gm PO twice daily for 10 days. |
ANS: B
Foscarnet is active against all known herpesviruses and is used in immunocompromised patients with acyclovir-resistant HSV or VZV. This patient is demonstrating resistance to acyclovir, so extending acyclovir therapy or increasing the acyclovir dose will not be effective. Valacyclovir is not approved for use in immunocompromised patients because of the risk for thrombotic thrombocytopenic purpura/hemolytic uremic syndrome.
PTS: 1 DIF: Cognitive Level: Application REF: pp. 1111-1112
TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
| a. | antiviral medications are not safe during pregnancy. |
| b. | intravenous antiviral agents will be used if an outbreak occurs. |
| c. | oral acyclovir [Zovirax] may be used during pregnancy. |
| d. | topical acyclovir [Zovirax] must be used to control outbreaks. |
ANS: C
Oral acyclovir is devoid of serious adverse effects and may be used safely during pregnancy. It is incorrect to tell this patient that antiviral medications are not safe during pregnancy. Oral acyclovir is used to suppress recurrent genital herpes near term; intravenous antiviral medications are not indicated. It is not necessary to rely on topical medications because oral acyclovir is safe.
PTS: 1 DIF: Cognitive Level: Application REF: pp. 1107-1108
TOP: Nursing Process: Planning
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
| a. | hydrate the patient during the infusion and for 2 hours after the infusion. |
| b. | increase the patient’s intake of foods rich in vitamin C. |
| c. | monitor urinary output every 30 minutes. |
| d. | provide a low-protein diet for 1 day before and 2 days after the acyclovir infusion. |
ANS: A
The nurse should ensure that the patient is hydrated during the acyclovir infusion and for 2 hours after the infusion to prevent nephrotoxicity. Increasing vitamin C would not help prevent nephrotoxicity. Monitoring urine output is important but would not help prevent nephrotoxicity. A low-protein diet is not indicated after an acyclovir infusion.
PTS: 1 DIF: Cognitive Level: Application REF: pp. 1107-1108
TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
| a. | “My vision may be blurred for 2 to 4 weeks after receiving the implant.” |
| b. | “Surgical placement of the implant is an outpatient procedure.” |
| c. | “The implant will remain in place permanently.” |
| d. | “The implant will slow progression of CMV retinitis.” |
ANS: C
Ganciclovir ocular implants must be replaced every 5 to 8 months and do not remain in place permanently. It is correct that vision may be blurred for 2 to 4 weeks after placement of the implant, that placement is an outpatient procedure, and that the implant will slow progression of CMV retinitis.
PTS: 1 DIF: Cognitive Level: Application REF: pp. 1110-1111
TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
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